CAD/CAM-assisted subperiosteal implant rehabilitation of a severely atrophic maxilla: A digital workflow case report

This case report describes the digital workflow and clinical outcomes of a customized CAD/CAM-assisted subperiosteal implant (SPI) used for the rehabilitation of a severely atrophic maxilla. A 53-year-old female patient presented with advanced peri-implantitis affecting multiple maxillary implants. After implant removal and a healing period, a patient-specific titanium SPI was designed and fabricated using cone-beam computed tomography and CAD/CAM technology. The implant was installed under conscious sedation, supporting a provisional prosthesis, followed by a definitive titanium-composite hybrid restoration. The digital workflow allowed precise adaptation of the implant to the patient's anatomy, minimizing surgical morbidity and eliminating the need for bone grafting.. This case suggests that a customized CAD/CAM-assisted subperiosteal implant (SPI) may represent a feasible treatment alternative in a single-case salvage scenario, achieving favorable aesthetic and functional outcomes in a severely atrophic maxilla where rehabilitation with conventional endosseous implants is not feasible.